Blue Signal Search
Our client is an innovative IT company providing groundbreaking solutions and services to the Healthcare industry. As a startup company, they have already proven extremely successful and continue to expand at a rapidly to keep up with demand. They are looking to hire a Director of Claims Auditing with a firm background in coding and auditing to provide leadership to the audit team. This role will evaluate data and provide direction, course correction, and project management improvement.
The Director of Claims Auditing will be responsible for effectively using business intelligence and technical skills to monitor operations and identify cross functional process improvement opportunities within the medical claims space. This is both an internal and external facing role as they will act as a team leader and mentor to staff as well as a direct point of contact and project manager to clients.
This Role Offers:
• Work alongside a small close-knit team empowered by their rapidly increasing success.
• Opportunity to play an instrumental role in the company’s growth and the development of products and processes as they scale.
• Be hands on throughout in the hiring and training of new team members, building out the platform and increasing the departments service offerings.
• A variety of career path opportunities and the freedom to work cross-functionally in many departments.
• Build strong, lasting relationships with industry professionals, clients, and stakeholders.
• A culture that is committed to going above and beyond industry and diversity standards with a mission to provide ethical and affordable care for all.
• Oversee all aspects of compiling, organizing, and conducting medical audits and claims.
• Work closely with clients and stakeholders as the direct point of contact throughout the entirety of the audit project.
• Analyzes trend reports to identify root causes of errors, providing solutions to the team and implementing them to processes.
• Work cross-functionally with the engineering team to collaborate when troubleshooting issues arise, communicating solutions to the client.
• Manage multiple, concurrent projects, prioritizes tasks, and adapt to frequent changes in departmental priorities.
• Develops procedures and processes for team adherence to claim review and documentation maintaining current knowledge of insurance practices and billing requirements.
• Using appropriate software tools, develops reports for the overall quality and day-to-day monitoring of claims data.
• Identify operational process improvement opportunities; generate and collaborate on the implementation of such improvements to achieve contractual and regulatory compliance.
• 8+ years of experience in the healthcare space.
• 3+ years of experience in a management or leadership role.
• In-depth experience in auditing records, financial risk management, financial analysis, and other related auditing services.
• Certified CMC and CMA required. Certified PMP, a plus.
• Bachelor’s degree in accounting or finance. Master’s degree, a plus.
• Excellent communication skills; strong attention to detail and process.
• Proven ability to lead a team and implement team strategy.
• Expert level technical skills and tools to organize and track data, such as Excel.
• Ability to manage multiple projects in a fast-paced, technically challenging, process-driven environment.
To apply for this job please visit www.bluesignal.com.